h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

>>There is no remedy left in homoeopathic remedies.

PEDANT ALERT!

A-Ahh! For any given dose of a homeopathic remedy, there's very, very little chance there'll be any remedy in it. But every few gazillion years you might find a molecule.

>>Here is the list of things I have tried for migrainesblah, blah, blah) yoga


As an aside, I can report that after suffering a persistent bad back, I found that a few minutes of back exercises a day, including yoga's 'the lion', has completely cured the pain. Plus I get an excuse to roll around on the floor.

Doesn't help your migraine of course, sorry to hear about it. Have you tried avoiding computers?

If anyone is interest in placebo this is a link to a blog that precies a paper showing that people who take placebo medication in a trial do better than those who don't.

And here's the catch - it isn't explained by any of the confoudners that they could think of:

http://neuroskeptic.blogspot.com/2012/01/take-your-placebos-or-die.html

God did it!

Tangentially related...on R4, Lord Melvyn of Buttermere and guests have just been talking about The Scientific Method.

http://www.bbc.co.uk/radio4/features/in-our-time/

The value of the empirical method, experimentation, etc. etc. in determining what will work and what won't are non-obvious. I don't think that those who haven't grasped it are necessarily idiots. And idiot might be someone who's been lucky enough to have been taught the method, who has taken it on trust and gone through the motions without thinking 'Yes - but *why*?'

I don't understand what you all have against herbs. Do they only sell pills at your chemist's and no herbs and other plant stuff? Ther was a time when people only had herbs and they *do* work. Like... what kind of bark had aspirin-like stuff in it? Why not? Arent there enough pills that have herb stuff in them?

I also believe that 'alernative medicine' does not automatically become 'medicine' if it works. It may not if there are pills that can be sold for higher prices and make more money than the 'alternative' treatment.

Our chemists do sell herbal remedies - but they're not prescribed by doctors*. And afaik they can't be advertised as being good for particular complaints - plus they have to pass the usual safety checks for any product sold. There have been some controversies.

Chinese Herbal Medicine practitioners have become common - they're in pretty much any small town or suburb. Again, there has been controversy over their licensing and the safety of some of their products.

And there's been a reasonably high-profile campaign against homeopathic remedies being sold in Boots. (Well - its profile has been high on sceptic blogs. )




* Caveat. None? Arnica cream is, perhaps. Others?

Can we count fish as herbs? (after all, some vegetarians eat them. )

Pharmaceutical grade fish oil can be prescribed for lowering cholesterol, and is sometime prescribed off-licence for the management of schizophrenia and bipolar disorder, for both of which it has been shown to have some efficacy.

"... what kind of bark had aspirin-like stuff in it? "

Aspirin is acetylsalicylic acid. It's found in willow bark.

The thing is, there's a whole boatload of other stuff in willow bark too, stuff you either don't need or that might not do you any good. Why have that? Why not just have the bit that *works*, purified, filtered and made as safe and clean as possible, instead of just scraped off the side of a tree and boiled a bit?

"I also believe that 'alernative medicine' does not automatically become 'medicine' if it works. It may not if there are pills that can be sold for higher prices and make more money than the 'alternative' treatment."

Ah - the old "big pharma" conspiracy theory. Let me fetch my tinfoil hat.

Here's the thing: big pharma got big by selling stuff that works, and selling lots and lots and lots of it. If there's something simple, like willow bark, that actually works, you can guarantee that a multinational company can apply to it industrial processes that will realise economies of scale.

I suggest, as an experiment, going into a pharmacists and buying a packet of generic aspirin, then going into a health-food shop and trying to buy something "herbal" for anything like as little money.

It's like the difference between organic free-range chickens and battery-farmed ones. Yes... that battery farming is "evil", if you care about chicken welfare. But you can't pretend it doesn't give you real chicken meat at one fifth the price or less.

All I have against herbs is this: if they work (and some of them do), then they're already in generic, cheap pills made by people like Bayer and Glaxo. If, for a given "herbal" substance, those companies are already knocking out tablets by the billion, it's a pretty good indication to me that the only money to be made selling that substance is by selling it to the gullible. Follow the money, every time.

"If, for a given "herbal" substance, those companies are NOT already knocking out tablets by the billion, it's a pretty good indication to me that the only money to be made selling that substance is by selling it to the gullible. Follow the money, every time."

Senna. I forgot senna.

Hoo's argument reminded me of this: http://xkcd.com/808/

EtB - you forgot about Piquet too. I hope you didn't forget about Dre.

I'm willing to believe that there are some herbal remedies that do work and haven't yet been pounced on by big pharma. I hope that they are soon, because once the research is done on how they work we'll know more about the body and we'll all be better off. I've heard of cases where people die because herbal medicines interact with conventional ones.



I actually think there's an argument that herbal medicines aren't really alternative medicines.

For instance: alternative medicines goes something like this.

- Treatment
- Treatment effects energy field, chi, body ley lines, something not proven to exist by science. In short the treatment works in a way that is contradictory to everything we know about science.
- That affects disease, and treats the whole person in a nice holistic way.

But herbal remedies don't do that, they interact with the body in a way that doesn't counteract science. There is no difference in the action of acetylsalicylic acid in willow bark to the action of acetylsalicylic acid in an aspirin tablet.



I still think that using herbal remedies can be dangerous. They can interact with real drugs and cause side effects, St Johns Wort interacts with Warfarin, and they are not proven to be effective in the same way that drugs are, so you don't know if you are getting an effective treatment or not. Also if you use them instead of a real treatment for something life threatening you are likely to die.

SoRB:

>>Here's the thing: big pharma got big by selling stuff that works, and selling lots and lots and lots of it.

nnn...I think you'll find there have been some reasonably high profile cases of money being made out of things that *don't* actually work but for which incomplete evidence has been presented. And it's hardly tinfoil hat stuff to say that.

Don't get me wrong. I love Big Pharma to bits. They've saved my life an my eyesight. But they's also cynical bastard5 and might just be capable of influencing medical practice to suite their own agenda.

I'm not sure your cost argument works, either. Quite possibly acetylsalycilic acid is easy enough to make and the demand is so high that the cost-benefit tradeoff works *for that product*. This may not be the case for others.

Then there's the fact that people might be turning to these because the mainstream products don't work (TEETH -Tried Everything Else, Tried Homeopathy etc. etc.) but some expensive, niche product with lower proven efficacy just might. Hell - Proper medics make the same sort of decision all the time - 'I've tried anti-depressants A to N. I doubt this dead expensive one one will work, either. The Trust won't thank me for it, but let's give it a shot.'

*I am absolutely not making a case for alternative medicine here*. I'm merely suggesting that your projection of gullibility onto others comes from your own, self-lauded misanthropy rather than any form of sound understanding of people's treatment decisions.

I very much dislike pills. I can't help it. Also doctors tell you to get herbs and make tea and stuff. At least here they do.

I fully agree EtB. There's also a cynical side of me that says it's in a pharma firm's better interests to keep you alive and ill rather than alive and healthy, so that they can keep selling you a painkiller, say, than it is to sell you a one-off cure. And there's a well-publicised scandal of under-reporting of negative results that Ben Goldacre's been banging on about for years now but that the government seems not to be minded to do anything about. I hold no brief for big pharma, beyond an appeal to view their conduct rationally.

And if you're doctor is telling you to take tea and herbs, I suspect it's because he thinks you're
(a) not actually ill
(b) ill with something non-serious and self-limiting or
(c) ill with something serious he can do nothing whatsoever about.

With the emphasis very much on the first two. When I was at uni I got sick with something someone told me might be glandular fever, which I was told could be serious. I saw a doc, who told me in no uncertain terms that I had a bad cold and a nasty sore throat, and instructed me to buy some generic paracetamol, some honey and some lemon juice, mix the latter two with some boiling water and take the first with it. He explicitly told me not to buy Lemsip or similar as they were a waste of money and contained only what I could get for a quarter the price if I went with his recipe. He promised it would go away on its own in a week or so, and that the paracetamol was just to deal with the pain in the meantime, which was all that could be done. Excellent advice, and of course 100% accurate as a prediction.

Incidentally...to lay out some credentials...I have sometimes been involved in advocating to mental health patients that they take medications. Often people with a psychiatric illness will be scared of psychiatric medications. Firtsly, there is an extremely negative public perception about them. Kurt Cobain really didn't help with 'Lithium'. And even for anti-depressants which many people reading will have taken, the tacit assumption is 'Well - I'll take these if I really, really have to - but really I should be able to do without.' Then there's the fact that finding the right medication - or, generally, combination of medicines - can be a hit and miss affair with lots of chopping and changing along the way. And let's not forget the side effects, some of which can be very nasty indeed (try loading up on Quetiapine if you don't believe me) and can affect one's life in the long term.

So the decision of which drug will to take is complex, multifactorial and temporal. It's genuinely difficult to get any meaningful evidence on which to make a decision. Many psychiatric illnesses are so individual in character that it's difficult to establish a meaningful evidence base. If patients - or their doctors make the wrong decision - are they idiots? I think not.

Now I *do* think people with psychiatric illness should follow their doctors' best guesses and have said so strongly when required. (a competent doctor will negotiate the treatment with their patient anyway).

Treatment decisions in other fields can be similar. *We should at least admit that it's a 'kin hard decision*. The right answer is no more obvious than that a bag of bumbum berries from Holland and Barrets is unlikely to work.

UK-wise, labeling of herbal remedies and treatments is required if they are making specific health claims (fairly recent change I think). For example, a recent ad campaign in the gents loos at bham train station for some herbal thingy for treating the symptoms of enlarged prostate (now that's targeted advertising, stand having a wee whilst looking at and advert, eye-level, for prostate treatment!) claimed treatment of symptoms of diagnosed enlarged prostate with a caveat of 'based on traditional use only'. I.e. they have to state that there is no medical/scientific backup for their claims. Bit of a cop out if you ask me since claiming effectiveness based on traditional use is a fallacy anyway so is still akin to claiming it works.

As for Big Farmer, alt-med in its many forms is pretty darned big itself. Country by country figures are in the billions, so the oft implied idea that alt-med is individual practitioners or cottage industries is wrong. OK, it ain't the size of Big Farmer, but it ain't exactly small and without huge financial resources itself.


mhra on alt med and herbal
http://www.mhra.gov.uk/Howweregulate/Medicines/Herbalmedicines/PlacingaherbalmedicineontheUKmarket/Unlicensedherbalremediesindividualpatients/index.htm

mhra on 'traditional use'
http://www.mhra.gov.uk/Howweregulate/Medicines/Herbalmedicinesregulation/RegisteredTraditionalHerbalMedicines/HowtoregisteryourproductundertheTraditionalHerbalMedicinesRegistrationScheme/Traditionaluse/index.htm

Key:
"the Directive specifically makes clear there is no requirement to present data on tests and trials relating to efficacy. The required evidence of the medicine's use for at least 30 years will often be indicative that there may well be as least some evidence as to the efficacy of the medicine."

>>I very much dislike pills. I can't help it. Also doctors tell you to get herbs and make tea and stuff. At least here they do.

Any comments, SoRB, on the relative health of the Austrian and British population? Their life expectancy is 77.9. Ours is 77.2. Not the whole story, but something.

End with a song:

http://www.youtube.com/watch?v=bR8XH3R95xE